Yamamoto et al developed a score for predicting intraoperative blood transfusions during hepatectomy for hepatocellular carcinoma. The authors are from Kyoto Prefectural University of Medicine.
Patient selection: hepatectomy for hepatocellular carcinoma
Parameters:
(1) alpha-fetoprotein (AFP) in ng/mL (method and reference range not reported)
(2) tumor diameter in centimeters
(3) platelet count in 10^3/L
(4) major hepatectomy (segments 1, 4, 5, 6, 7, and 8; 1, 2, 3, 4, 5, and 8; 5, 6, 7, and 8; 2, 3, and 4; 4, 5, and 8; 5 and 8; 6 and 7; 4)
|
Parameter
|
Finding
|
beta-coefficient
|
Points
|
|
AFP
|
< 80 ng/mL
|
0
|
0
|
|
|
>= 80 ng/mL
|
0.914
|
1
|
|
tumor diameter
|
< 4.0 cm
|
0
|
0
|
|
|
>= 4.0 cm
|
0.943
|
1
|
|
platelet count
|
> 100,000
|
0
|
0
|
|
|
<= 100,000
|
1.732
|
2
|
|
major hepatectomy
|
no
|
0
|
0
|
|
|
yes
|
1.074
|
1
|
total score =
= SUM(points for 4 parameters)
X =
= SUM(beta-coefficient) - 2.833
probability of blood transfusion =
= 1 / (1 + EXP((-1) * X)
Interpretation:
• minimum score: 0
• maximum score: 5
• The higher the score the greater the likelihood of a blood transfusion.
|
Total Score
|
Blood Transfusions
|
|
0
|
3%
|
|
1
|
10%
|
|
2
|
38%
|
|
>= 3
|
45%
|
Performance:
• The area under the ROC curve is 0.76.
